'I'm one of the lucky ones' - Inspirational Irish grandmother who's fought cancer three times
For many, it's just the first step in a process of recovery. Alex Meehan speaks to patients about reconciling a fear for the future with a need to live well for today
The word cancer can strike fear in the hearts of even the most healthy people but it's worth considering that there are currently more survivors than sufferers of the disease in Ireland. And despite the incidence of diagnoses rising, the good news is that a wider variety of cancers are treatable than ever before.
But just what does it mean to be 'cured' of cancer? For most people, the news that their cancer is in remission is an enormous relief, allowing them to get back to living life to the full. For others though, the side effects of the treatment they've had to go through can stay with them for years to come.
"Remission is the term used to describe when cancer has been cleared by surgery and/or chemotherapy or radiotherapy. Someone is in remission when all the modalities have been done and they have no visible cancer on scans," says Dr Derek Power, Consultant Medical Oncologist in the Mercy and Cork University Hospital.
"It's very hard to generalise about who will go into remission and who won't because there are many different kinds of cancer and lots of different kinds of people. There are certain cancers that by the time the patient realises they have them, they can be very advanced and hard to treat."
Some, like pancreatic and lung cancer, are very difficult to treat, while others have a relatively high remission rate. For example, up to 60pc of people who present with lung cancer have advanced disease that isn't curable.
"With bowel cancer, for example, of the 2,500 people a year that contract it, 50 to 60pc have curable disease and could go into remission. With melanoma, that is even higher and 70 to 80pc go into remission."
May Ryan (78) has had cancer three times. A retired teacher and dressmaker from Templeogue, she was diagnosed with breast cancer in 1985, colon cancer in 2004 and was recently given the all-clear after treatment for liver and bowel cancer.
"I am a huge believer in positive thinking. I think our immune system and health in general is strongly linked to our thoughts and I sometimes think that the thing that kills people is the fear of cancer rather than the cancer itself.
"I know that sounds simplistic and I don't mean to belittle the condition, but I have always found that those who got up, took hold of their health and remained positive had better outcomes," she says.
May has finished with any kind of medical supervision or medication and lives what she describes as a perfectly normal life.
"One thing I find incredibly useful is tai chi. It helps me hugely with positive thinking and I believe the philosophy and exercise in it contributes enormously to my well-being on all levels."
May would like to see people talk more openly about cancer and to access the support groups that are available.
"Cancer is an incredibly lonely condition. At night, when everything's quiet and everybody's asleep, that's when you are alone with your thoughts. Nobody can share that place with you because you have to face cancer alone. But if you can share those feelings with someone, it does help you to take them out and look at them in the cold light of day," she says.
Margaret Doyle (80) lives in Dublin and has been living with carcinoid cancer for 25 years. Diagnosed in 1993, she receives CT scans every 12 months along with other ongoing treatments. In 2010, tests showed signs of tumours re-emerging on her liver and in 2012, she underwent a successful embolisation on her liver.
"I have a very rare type of cancer, and it's very slow. It doesn't really go into remission and it does form tumours, so I have to get a hormone injection every month at the hospital and that holds it at bay," she says.
Margaret's condition means she has to live with pain, digestive and eliminatory problems and hot flushes.
"It's not so much pain as discomfort. I've had it for 25 years, or at least that's when it was diagnosed, so it's actually possible that I've had it a lot longer and just didn't know. Originally, I had a condition called diverticular disease which interferes with your colon," she says.
"While I was at the hospital getting checked, they took out a bit of my colon to improve my quality of life but while they were doing that, they found a tumour that hadn't shown up on any other tests I'd had. It came back from the lab as a carcinoid tumour."
Like anyone would be, Margaret was initially shocked to be told she had cancer, but a realisation about life arrived not long afterwards.
"It's a terrible shock to be told you have cancer. You don't know whether you're coming or going and I was very down in the dumps for a week or two, but then I realised I could be knocked down by a car in the morning or have a heart attack. Nobody really knows what's in their future, sick or well, so all you can really do is think positively and make the best of life," she said.
"You have to live your life as if you have no assurances about the future because you don't. If it's going to happen, it will and there's just no point in getting yourself into a state about something that might not even happen."
Spending time around other cancer patients also taught Margaret that bad as her situation was, it could have been a lot worse.
"Of course, there'll be good days and bad days, but if you visit cancer wards you'll see a lot of very ill people, so you have to reflect that, actually, you're not doing that badly," she says.
"When I was diagnosed with this 25 years ago, there were a lot of healthy people around me who have since passed away. I'm the one with cancer, and yet here I am soldiering on like a bad penny. So there's a lesson in that."
According to Dr Power of the Mercy and Cork University Hospital, whether cancer comes back when someone is in remission or not is a great unknown. If doctors knew the definitive answer to that question, they'd also know just what causes cancer in all the cases where there are no risk factors present.
"It's estimated that 40 to 50pc of all cancers are preventable through diet, exercise and lifestyle. But it's otherwise very difficult to say what causes it. It's not nice to think about but you can basically just be unlucky, and it follows that even if you're in remission, you can be unlucky and have it come back," he said.
There is a growing movement to help cancer sufferers live through the disease and manage their remission as well as possible, supported by the annual National Conference for Cancer Survivorship, organised by the Irish Cancer Society.
Watch May Ryan discuss life in remission at independent.ie/mycancerstory.
See www.cancer.ie/daffodilday or text 'Daff' to 50300 to donate €4